The first non-opoid painkiller

Summary

In the nineteenth century, the invention of anesthesia was considered a gift from God. But post-operative pain relief has continued to rely on opioids, derivatives of opium, the addictive substance employed since ancient times. Although no other drug has managed to match the rapid, potent, and broadly effective relief delivered by opioids, their side effects have led to decades of addiction and overdose, leaving researchers keen to find a better solution.This all changed in January 2025, when the FDA approved Vertex Pharmaceuticals’s Journavx (suzetrigine): the first non-opioid pain reliever suitable for treating post-surgery pain. Clinical trials found no signs of the problematic side effects associated with opioids: no drug abuse, tolerance, or withdrawal. But this was not an easy win: Vertex and other pharma companies spent decades searching for drugs like this to no avail.Opioids are used primarily to treat nociceptive pain, pain caused by tissue damage from injury or disease. This damage activates nearby nociceptors: sensory neurons that signal physical or chemical harm. These nociceptors send signals up to the central nervous system – the brain and spinal cord – and the brain then creates a localized sensation of pain, drawing your attention to the threat.Traditional opioids mimic opium, a compound found in the poppy plant that contains morphine. Opioids alleviate pain by acting on one of the three main opioid receptors, mu (μ) opioid receptors, which are distributed throughout the central nervous system, particularly in the brain. When opioids bind to the brain’s mu receptors, this suppresses incoming pain signals from the damaged site’s nociceptors, preventing the brain from creating the sensation of pain even when tissue damage is present.Our bodies naturally produce their own opioids – such as endorphins, endogenous morphine – to briefly blunt pain during moments of stress or injury. However, these are far weaker and shorter-acting than prescription opioid...